MEDICARE: SOULSHINE HOME CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1326905597
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOULSHINE HOME CARE LLC

Provider Business Mailing Address
First Line	:	23815 DORMONT AVE
Second Line	:
City	:	WARREN
State	:	MI
Zip	:	48091-1824
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	23815 DORMONT AVE
Second Line	:
City	:	WARREN
State	:	MI
Zip	:	48091-1824
Country	:	US
Telephone Number	:	313-349-8376
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NAHIDA EKLIM
Credential	:
Telephone Number	:	313-349-8376

Provider Enumeration Date	:	01/08/2026
Last Update Date	:	01/08/2026

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